Which Chart Elements Accurately Identify Emergency Department Visits for Suicidal Ideation or Behavior?

Arias, Sarah A.; Boudreaux, Edwin D.; Chen, Elizabeth; Miller, Ivan W.; Camargo, Carlos A.; Jones, Richard N.; Uebelacker, Lisa A.

doi:10.1080/13811118.2018.1472691

Cited by 5 publications

(6 citation statements)

References 13 publications

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“…Inconsistencies in findings may also be attributable to the lack of an internationally accepted protocol for recording data on suicide attempts. In fact, only limited data are available on attempts, based on self-reports in wider community surveys and on descriptions of self-inflicted lesions in the records of hospital emergency departments and other health centers [2,27]. However, it seems that the majority of people who die by suicide or attempt suicide have no previous contact with a mental health center or hospital [7,18], which was observed in only one-third of suicide victims in one study [28].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Suicide Attempts and Suicides in the General Population of Andalusia (Spain)

Mejías-Martín

Castillo

Rodríguez-Mejías

et al. 2019

IJERPH

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Discrepant results have been published by studies comparing deaths by suicide with attempted suicides. This study aimed to determine factors associated with suicides and attempted suicides in Andalusia (Spain) between 2007 and 2013, comparing sex, age, year, and suicide method between these populations. A retrospective study was conducted of data on deaths by suicide and attempted suicides over a seven-year period, calculating the sex and age rates for each behavior. Adjusted Poisson regression was used to analyze the association with study variables, and incidence rate ratios were estimated. During the seven-year study period, 20,254 attempted suicides and 5202 deaths by suicide were recorded. The prevalence of attempted suicide did not differ between the sexes, whereas the prevalence of deaths by suicide was three-fold higher among males than among females and increased with higher age. The most frequently used method was the same in males and females for suicide attempts, but differed between the sexes for suicides. The combined influence of sex and age was greater in the model for death by suicide than in the model for attempted suicide. The key differentiating factor was the method used, while the finding of greatest concern was the suicide behavior among the elderly. Preventive strategies should take these differences into account.

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Section: Introductionmentioning

confidence: 99%

Factors Associated with Suicide Attempts and Suicides in the General Population of Andalusia (Spain)

Mejías-Martín

Castillo

Rodríguez-Mejías

et al. 2019

IJERPH

View full text Add to dashboard Cite

show abstract

“…Analysis of service utilization patterns would be affected if patients interacted with institutions outside the scope of Rhode Island's HIE. Future studies would benefit from access to clinical notes given that Arias et al (2019) have shown that ICD codes are a poor indicator of suicide‐related ED visits. Of note, this was a descriptive study that did not directly compare the rates of SI/SB in the unhoused population versus the general population.…”

Section: Discussionmentioning

confidence: 99%

Characterizing suicidal ideation, suicidal behaviors, and service utilization among unhoused individuals using a health information exchange

Arias

Kunicki

et al. 2023

J Clin Psychol

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IntroductionUnhoused individuals have high rates of suicidal ideation (SI) and suicidal behaviors (SB), but few have studied the relative timing of homelessness and SI/SB. Our study examines the potential to use state‐wide electronic health record data from Rhode Island's health information exchange (HIE) to identify temporal relationships, service utilization, and associations of SI/SB among unhoused individuals.MethodsWe use timestamped HIE data for 5368 unhoused patients to analyze service utilization and the relative timing of homelessness versus SI/SB onset. Multivariable models identified associations of SI/SB, hospitalization, and repeat acute care utilization within 30 days from clinical features representing 10,000+ diagnoses captured within the HIE.ResultsThe onset of SI typically precedes homelessness onset, while the onset of SB typically follows. Weekly rates of suicide‐related service utilization increased over 25 times the baseline rate during the week before and after homelessness onset. Over 50% of encounters involving SI/SB result in hospitalization. Of those engaging in acute care for suicide‐related reasons, we found high rates of repeat acute care encounters.ConclusionHIEs are a particularly valuable resource for understudied populations. Our study demonstrates how longitudinal, multi‐institutional data from an HIE can be used to characterize temporal associations, service utilization, and clinical associations of SI and behaviors among a vulnerable population at scale. Increasing access to services that address co‐occurring SI/SB, mental health, and substance use is needed.

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“…For example, analysis of public health trends in child mental health using EHRs often relies on data stored in structured fields, most commonly, International Classification of Disease codes. However, structured data alone is often inaccurate in the discovery of mental health and suicide-related visits [28,29]. There has also been scarce adaptation of natural language processing and other text processing methods to detect child mental health conditions from large-scale EHRs [30].…”

Section: Cohort Discovery Recognizes Patients With Similar Attributesmentioning

confidence: 99%

Applications of Clinical Informatics to Child Mental Health Care: a Call to Action to Bridge Practice and Training

et al. 2022

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Which Chart Elements Accurately Identify Emergency Department Visits for Suicidal Ideation or Behavior?

Abstract: These findings highlight the use of key discrete fields in the medical record that can be extracted to facilitate identification of whether an ED visit was suicide-related.

Cited by 5 publications

References 13 publications

Factors Associated with Suicide Attempts and Suicides in the General Population of Andalusia (Spain)

Factors Associated with Suicide Attempts and Suicides in the General Population of Andalusia (Spain)

Characterizing suicidal ideation, suicidal behaviors, and service utilization among unhoused individuals using a health information exchange

Applications of Clinical Informatics to Child Mental Health Care: a Call to Action to Bridge Practice and Training

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